UWorld

Question 1

Most life threatening complication of Guillain-Barre and the test performed to check for it

Answer 1

Respiratory failure; Do spirometry

Question 2

Guillain-Barre presentation

Answer 2

Ascending paralysis/muscle weakness and areflexia after a respiratory or GI infection like Campy

NOTE: Botulism is descending paralysis

Question 3

Indications for critical care in Guillain-Barre

Answer 3

1. FVC

Question 4

Loud first heart sound with mid-diastolic rumble at the apex

Answer 4

Mitral stenosis, likely due to RF

Question 5

Treatment for Acute Rheumatic Fever

Answer 5

Penicillin

Question 6

Tx time for RF without carditis

Answer 6

5 yrs or until 21 yrs old (every 4 wks IM), whichever is longer

Question 7

Tx time for RF with carditis but without valvular damage

Answer 7

10 yrs or until 21 yrs old, whichever is longer

Question 8

Tx time for RF with carditis and persistent damage

Answer 8

10 yrs or until 40, whichever is longer

Question 9

Difficulty swallowing, agitation, disorientation, drooling and facial grimacing. What is it and what vector?

Answer 9

Rabies from a bat

You get hydrophobia and aerophobia

Question 10

Pubertal gynecomastia - what do?

Answer 10

Reassurance. It will go away within 2 years normally

Question 11

Projectile non-bilious emesis with olive shaped abdominal mass. What is it and what do you do?

Answer 11

Hypertrophic pyloric stenosis; You rehydrate and normalize electrolytes before surgery

Question 12

1st line behavioral and pharmacotherapy for nocturnal enuresis

Answer 12

Behavioral: enuresis alarm when avoidance of liquid at night and reward system fails

Pharmacotherapy: Desmopressin

Note: second line is TCA

Question 13

Why not TCA before desmopressin for nocturnal enuresis

Answer 13

Worse side effects such as suicidality and cardiotoxicity

Question 14

Complete androgen insensitivity - take out the cryptorchids? If so, when?

Answer 14

Yes due to 1-5% chance of malignant transformation. Do so after puberty.

Question 15

Bilious emesis with no stool in vault - what do? what think it is?

Answer 15

Do a contrast enema, think of meconium ileus which is pathognomonic for cystic fibrosis - obstruction of terminal ileum

Question 16

Edward’s syndrome heart defect and murmur sound

Answer 16

VSD - holosystolic murmur best heard at LL sternal border

Question 17

Microcephaly, micrognathia, rocker bottom feet, overlapping fingers, absent palmar creases, VSD

Answer 17

Edwards syndrome

Question 18

Primary amenorrhea workup:

Answer 18

1. Is uterus present?
2. If yes, then serum FSH; if no then karyotype
3. FSH increased then karyotype, decreased then cranial MRI